Cutaneous Adverse Reactions of Amiodarone

Jaworski, Krzysztof; Walecka, Irena; Rudnicka, Lidia; Gnatowski, Maciej; Kosior, Dariusz A.

doi:10.12659/msm.890881

Cited by 50 publications

(14 citation statements)

References 26 publications

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“…[10][11][12][13][14][15][16] other drugs reported to induce skin hyperpigmentation are amiodarone and some antihypertensives such as diltiazem, telmisartan and amlodipine. [17][18][19][20][21][22][23][24][25] Calcium channel antagonists block the inward movement of calcium by binding to the L-type calcium voltage-gated channels located on the vascular smooth muscle, cardiac myocytes and cardiac nodal tissue causing vascular smooth muscle relaxation and vasodilation coronary arteries and peripheral arterioles, but not veins. They also decrease cardiac contractility (negative inotropic effect), automacity at the SA node and conduction at the AV node.…”

Section: Discussionmentioning

confidence: 99%

Photodistributed Hyperpigmentation Induced by Lercanidipine

Giménez-García¹

2018

Dermatol Open J

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Section: Discussionmentioning

confidence: 99%

Photodistributed Hyperpigmentation Induced by Lercanidipine

Giménez-García¹

2018

Dermatol Open J

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“…Phototoxicity affects 25-75% of patients treated with amiodarone [114]. Clinical manifestations associated with phototoxicity of amiodarone include a burning sensation, erythema, and edema of the face, neck, and hands following a few minutes after sun exposure [115,116]. Skin reactions reported by patients also include a fine maculopapular rash and a slate-grey discoloration of sun-exposed areas.…”

Section: Cardiovascular Drugsmentioning

confidence: 99%

Drug-Induced Photosensitivity—From Light and Chemistry to Biological Reactions and Clinical Symptoms

et al. 2021

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Photosensitivity is one of the most common cutaneous adverse drug reactions. There are two types of drug-induced photosensitivity: photoallergy and phototoxicity. Currently, the number of photosensitization cases is constantly increasing due to excessive exposure to sunlight, the aesthetic value of a tan, and the increasing number of photosensitizing substances in food, dietary supplements, and pharmaceutical and cosmetic products. The risk of photosensitivity reactions relates to several hundred externally and systemically administered drugs, including nonsteroidal anti-inflammatory, cardiovascular, psychotropic, antimicrobial, antihyperlipidemic, and antineoplastic drugs. Photosensitivity reactions often lead to hospitalization, additional treatment, medical management, decrease in patient’s comfort, and the limitations of drug usage. Mechanisms of drug-induced photosensitivity are complex and are observed at a cellular, molecular, and biochemical level. Photoexcitation and photoconversion of drugs trigger multidirectional biological reactions, including oxidative stress, inflammation, and changes in melanin synthesis. These effects contribute to the appearance of the following symptoms: erythema, swelling, blisters, exudation, peeling, burning, itching, and hyperpigmentation of the skin. This article reviews in detail the chemical and biological basis of drug-induced photosensitivity. The following factors are considered: the chemical properties, the influence of individual ranges of sunlight, the presence of melanin biopolymers, and the defense mechanisms of particular types of tested cells.

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“…Usually, symptoms develop within two hours of sun exposure in the form of burning sensation and erythema, and sometimes occur as graphite-gray pigmentation in sun-exposed areas. Th e incidence in the population of pa- tients with prolonged use of amiodarone reaches nearly 75% according to various sources, but they are often misdiagnosed or overlooked 18 . After drug discontinuation, photosensitivity may last for up to another four months, with gradual fading of lesions over months to years.…”

Section: Drugs and Substances Associated With Sensitivity To The Sunmentioning

confidence: 99%

“…Although dermatological complications and photosensitivity usually do not infl uence the outcome of therapy and rarely cause discontinuation of treatment, they have great impact on the patient quality of life 18,36 .…”

Section: Diagnosis and Th Erapymentioning

confidence: 99%

Drug-Induced Photosensitivity – a Continuing Diagnostic Challenge

Lugović-Mihić

Duvančić

Ferček

et al. 2017

acc

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SUMMARY -When taking diff erent drugs, their possible side eff ects on the skin should be considered, including skin reactions connected to photosensitivity. Th is photosensitivity caused by drugs can appear as phototoxic reactions (which occur more often) or photoallergic reactions (which occur less often and include allergic mechanisms). Th e following drugs stand out as medications with a high photosensitivity potential: nonsteroidal anti-infl ammatory drugs (NSAIDs), cardiovascular drugs (such as amiodarone), phenothiazines (especially chlorpromazine), retinoids, antibiotics (sulfonamides, tetracyclines, especially demeclocycline and quinolones), etc. In recent years, photosensitive reactions to newer drugs have appeared, e.g., targeted anticancer therapies such as BRAF kinase inhibitors (vemurafenib, dabrafenib), EGFR inhibitors, VEGFR inhibitors, MEK inhibitors, Bcr-Abl tyrosine kinase inhibitors, etc. In patients taking drugs over a longer period of time (e.g., NSAIDs, cardiovascular drugs, etc.), a particular problem arises when an unrecognized drug-induced photosensitivity on the skin manifests in summer months. When taking patient histories, the physician/dermatovenereologist should bear in mind that any drug the patient is currently taking may be the cause of skin reactions. Th erefore, patients who use potentially photosensitive drugs and treatments on a long term basis should be warned of the possibility of these side eff ects on their skin and advised to avoid direct exposure to sunlight and to use adequate photoprotection. If patients carefully protect themselves from the sun, it is often not necessary to stop treatments that include photosensitive drugs. If such reactions appear, anti-infl ammatory and antiallergic therapies should be introduced.

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Cutaneous Adverse Reactions of Amiodarone

Cited by 50 publications

References 26 publications

Photodistributed Hyperpigmentation Induced by Lercanidipine

Photodistributed Hyperpigmentation Induced by Lercanidipine

Drug-Induced Photosensitivity—From Light and Chemistry to Biological Reactions and Clinical Symptoms

Drug-Induced Photosensitivity – a Continuing Diagnostic Challenge

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